Clear Aligner Discomfort Guide: Cuts, Sores, Pains, and More

As a clear aligner patient, you might incorrectly assume that your appliances are less injury averse than braces. After all, you don’t have a wire and brackets constantly affixed to your teeth that you’re constantly concerned about maintaining. Unfortunately, minor injuries can sometimes still happen with clear aligners, just as they sometimes can with braces.

Mail-order aligners especially can be breakage-prone, as they’re often made with less durable thermoplastics, and often less precise fit without the help of a trusted, licensed, in-office orthodontist. But like everything else in life, no appliance is 100% invulnerable to being affected by outside pressures.

You may have already seen our guide on reducing pain whilst wearing aligners, but we saw fit to produce a guide exploring the common causes of that pain. Keep reading for a comprehensive overview of common clear aligner cuts to watch out for.

Clear Aligners Hurting Tongue

It takes a few days for your teeth to become acclimated to a newly-fitted aligner. During this time, the sides of your tongue may encounter friction with the edges of your new trays. This rubbing may result in subsequent irritation, abrasion, and discomfort. If enough friction occurs, this could sometimes result in cutting the tongue.

Tongue cuts are especially excruciating because it’s very difficult to circumvent them. Your tongue remains in continuous contact with the food and beverages you need to survive, meaning that it’s almost inevitable that a certain level of discomfort will be triggered.

Perhaps this sounds like nothing but bad news, but the good news here is that your mouth will usually get used to these seams on its own. In the meantime, though, there are precautions and pain relief measures you can take to lessen the likelihood of clear aligner tongue irritation, such as:

Applying orthodontic wax or topical pain relievers
Trimming or smoothing out edges
Seating the aligner better using Chewies, Movemints, or a bite stick

If pain persists though, and you don’t think your aligner fit is naturally acclimating, let your orthodontist know. They can determine whether or not a treatment revision would be needed.

Aligners and Tongue Thrust

Tongue thrust refers to the orthodontic bad habit of pressing your tongue too far forward to the point that it pushes against the teeth. This habit is far more common among infants and children than it is the adolescents and adults that are usually clear aligner candidates, with a study published in DDD estimating that nearly 3/4ths of children from grades 1-3 are guilty of it.

So why would this habit be of concern while you’re wearing removable clear aligners? For one, it obviously increases the friction bearing down on your aligners. Furthermore, it’s also been correlated with certain types of malocclusion, such as overbite and overjet.

Though children are vulnerable to having their developing bite harmed by tongue thrust, as they are by thumb sucking and pacifier overuse, the adult mouth isn’t entirely immune to malformations. If it was, we obviously wouldn’t have a sizable body of our clientele coming in!

So, to effectively reign this habit in, it’s recommended that patients who partake in tongue thrusting:

Undergo myofunctional therapy
Complete tongue exercises
Use a tongue crib appliance, if necessary

A tongue crib is a metal appliance that fits the top of your mouth. This device creates a “gate” that prevents the tongue from pressing against the roof and is designed to discourage movement.

An experienced orthodontist can effectively determine whether or not you would need to wear one before clear aligner treatment, and will want to complete it before so they aren’t conflicting.

Aligner Lip Discomfort

Clear aligners are not a cosmetic lip treatment; even if it appears there are changes, they will not make any direct changes to the lips. But because an appliance will round out your mouth, your lips may appear to look bigger while wearing your appliance.

What may also be apparent while wearing your appliance is irritation on that side of your mouth. Furthermore, since clear aligners capture saliva, it may leave your lips more prone to drying and capping.

To mitigate this effect, the aforementioned pain relief strategies that work well with the tongue will also work well with your lips. Furthermore, to deal with the discomfort that stems from lip drying and chapping, regularly drinking water (which is the only drink safe to drink with aligners in) and using quality, nonabrasive lip balm.

Aligners Cutting Cheeks

Just as aligner edges can rub against the tongue during the first few days, they can also rub against your cheeks. To mitigate the risk of this, all of the above strategies are advised, as is cutting around the extra aligner space, sensibly and responsibly. You can do this by:

Using a nail file or emery board to file down the edges
Using dental wax to help flatten them
Having an orthodontist cut them to your convenience

We would recommend the last option the most, as a trusted orthodontist will have the sufficient expertise needed to know how to cut your aligners thoroughly and precisely. Under any circumstances, do NOT trim or cut them with an unwieldy tool like scissors, as it’s far too easy to just cause further breakage.

Mouth Sores from Aligners

You may notice an increase in gum irritation and canker sores after wearing your aligners, but rest easy knowing that these discomforts should be short-lived. For deeper relief, cold liquids and soft cold snacks will naturally provide a soothing effect, and on the flip side, you should avoid hard, extremely crunchy foods that will only serve to cause deeper soreness and irritation.

Placing an icepack around your cheeks is another way to administer deeper, anti-inflammatory relief. But if you implement all of the above strategies and still notice lingering discomfort, if irritation still persists long after the edges have been trimmed, or if you suspect any maladies out of the ordinary, let your orthodontist know ASAP!

They will offer the clarity, cogence, and competence needed to effectively strike at the root of your problems. If these lingering pains persist, you don’t have to power through them alone. At the first sign of long-term discomfort, help your care provider help you!